Preliminary study of the effectiveness of trauma care system at a medical center in Tainan

Objectives: To evaluate the quality of care for trauma patients following the implementation of continuous quality improvement (CQI) in a trauma care system. Methods: This was a retrospective chart review study using the trauma registry database of a medical center in Tainan from 2011 to 2015. The patients were classified into two groups: the years 2011-2013 (early period, N=895) and 2014~2015 (late period, N=724). Chi-square and t-test analyses were used to examine the indicators: duration of stay in the emergency room (ER) for emergency transcatheter arterial embolism (TAE)/torso surgeries, waiting time after scheduled for torso surgery, and length of stay (LOS)/mortality rate of patients with an Injury Severity Score (ISS) greater than 15. Results: The average ISS of the late period group was significantly higher (18.62 vs. 15.09) and the duration of stay in the ER for emergency TAE was significantly lower (117.94 vs. 143.52) than those of the earlier period group. In addition, the LOS declined significantly (16.27 vs. 21.13), and the mortality rate was significantly reduced (1.03% vs. 5.34%) among patients with an ISS of 16-24. Conclusions: CQI in a trauma care system was effective in the ER management of trauma with significant reductions in LOS and mortality rate in patients with an ISS of 16-24. (Taiwan J Public Health. 2016;35(6):587-594).